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Title

Significance of ethnicity in the risk of acute graft-versus-host disease and leukemia relapse after unrelated donor hematopoietic stem cell transplantation

Authors
Morishima, Yasuo
Kawase, Takakazu
Malkki, Mari
Morishima, Satoko
Spellman, Stephen
Kashiwase, Koichi
Kato, Shunichi
Cesbron, Anne
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Collaboration
Published in Biology of Blood and Marrow Transplantation. 2013, vol. 19, no. 8, p. 1197-1203
Abstract The significance of patient and donor ethnicity on risk of acute graft-versus-host disease (GVHD) and disease relapse after unrelated donor hematopoietic cell transplantation (HCT) is not known. A total of 4335 patient-donor pairs from the International Histocompatibility Working Group in HCT met the following 3 criteria: (1) HLA-A, -B, -C, -DRB1, and -DQB1 allele matched donor, (2) diagnosis of leukemia, and (3) non-T cell depleted GVHD prophylaxis. Posttransplantation risks of acute GVHD and leukemia relapse were defined in Asian/Pacific Islander, white, African American, Hispanic, and Native American patients that underwent transplantation from donors with the same self-described background. Asian patients had a significantly lower incidence of acute GVHD (Japanese patients: 40.0% grades II to IV and 15.3% grades III to IV; non-Japanese Asian patients: 42.1% grades II to IV and 15.7% grades III to IV) compared with white patients (56.5% grades II to IV and 22.6% grades III to IV) (P < .001). The hazard ratio of acute GVHD for white patients was significantly higher than for Japanese patients. Unexpectedly, the hazard ratio of leukemia relapse in white patients with early disease status was also significantly higher than that in Japanese patients. These results provide a platform for future investigation into the genetic factors for unrelated donor HCT and clinical implications of diverse ethnic background.
Keywords Acute DiseaseAdultAllelesAsian Continental Ancestry GroupEuropean Continental Ancestry GroupFemaleGraft vs Host Disease/epidemiology/ethnology/etiologyHLA Antigens/genetics/immunologyHLA-DQ beta-Chains/genetics/immunologyHLA-DRB1 Chains/genetics/immunologyHematopoietic Stem Cell Transplantation/adverse effects/methodsHumansLeukemia/epidemiology/ethnology/etiologyMaleNeoplasm Recurrence, Local/epidemiology/ethnology/etiologyRecurrenceRisk FactorsSurvival AnalysisTissue Donors
Identifiers
PMID: 23747601
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Research group Compatibilité tissulaire et transplantation clinique (562)
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MORISHIMA, Yasuo et al. Significance of ethnicity in the risk of acute graft-versus-host disease and leukemia relapse after unrelated donor hematopoietic stem cell transplantation. In: Biology of Blood and Marrow Transplantation, 2013, vol. 19, n° 8, p. 1197-1203. https://archive-ouverte.unige.ch/unige:77650

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Deposited on : 2015-11-25

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